Weekend #3 = Fun at the Guesthouse

My last weekend at Tenwek was filled with fun and laughter!!! We kicked the weekend off with movie night in the activity center. All the short-term missionaries were present to watch "Remember the Titans." I've seen it at least 10 times and it never fails, when "Superman" gets paralyzed my eyes fill with tears! Haha!



Saturday was a day filled with relaxation! It was my first day off while in Tenwek. I enjoyed a 2-mile jog....meaning I was out of breath and struggling the whole time! We are at a high elevation here, so simply walking the hill to the hospital exerts me! I spent the rest of the day being productive and working on school work. Saturday night, we celebrated with games, popcorn, and brownies...what a treat!!! We played a vigorous game of "Mad Gab" and of course my team won! Lyle and David were pro's! It was a very competitive night! Dr Spears was kind enough to host game night in her very very lovely house! We were all a bit taken back at house extravagant her house was...a house this nice is not quite so common in Kenya. All in all, a wonderful weekend filled with friends!

Game Night!





Dr Spear's Stunning House:





I love this nativity scene!


Sunday started off a bit earlier than usual. A group, including: Trent, Lyle, Nathan, Dr Greene, Cheryl, David, and myself, all awoke at 4:30am to hike up to Motigo! By 5:40am we reached the peak, well in time to see the sun rise! I stood in awe of God's creation...it was breathtaking! Our group shared in a time of prayer as the sun began to rise. The second the sun peaked over the farthermost mountain all of our cameras began to click. It was a beauty that a picture cannot give justice to, but I will still display some of my photos!











A boy standing at the peak of the mountain:

Group Pics:



David and Cheryl Lee:

Our decent down our muddy path!


After our quick decent from the mountain, we all rushed to get to breakfast which was being hosted by Barbara Pinkley, one of the long-term missionaries. As soon as we finished our breakfast, we went to church service. During worship, Nathan joined the musicians and played guitar. Along with the rest of the musicians, the boy displayed in the picture below was stroking away on his guitar...it was adorable!

God Works in Mysterious Ways

Every Wednesday starts with Doctor's Devotional at 8am; it’s a wonderful time of fellowship with all the doctors. This morning Dr Greene presented the devotional over “Hearing Voices.” He spoke of the many voices we hear in our head throughout the day: God’s, the devil’s, the worlds, our own. How do we know which voices are from God? How do we know we are listening to God’s voice?
In the parable of the sewer it states: “Still others, like seed sown among thorns, hear the word; 19but the worries of this life, the deceitfulness of wealth and the desires for other things come in and choke the word, making it unfruitful.” Mark 4:18-19
Disobedience makes it hard to hear God’s voice; it makes the word unfruitful! Following God is not a one time commitment; we must die to Him each and every day! As Dr Greene stated, “If you get on a train of thought that is not from God, then get off that train.” Daily we must rebuke the devil, give praise to God, spend time in devotion with God, pray aloud, and pray often! Spending time with God makes His voice more apparent to us. We must sharpen on instincts so we can recognize the “Voice of Truth.”

Casting Crowns “Voice of Truth”

Oh, what I would do to have the kind of faith it takes to climb out of this boat I'm in onto the crashing waves, to step out of my comfort zone. Into the realm of the unknown where Jesus is, and he's holding out his hand.

But the waves are calling out my name and they laugh at me reminding me of all the times I've tried before and failed. The waves they keep on telling me time and time again "Boy, you'll never win, you'll never win.”

But the Voice of truth tells me a different story. The Voice of truth says "do not be afraid!" And the Voice of truth says "this is for My glory." Out of all the voices calling out to me I will choose to listen and believe the Voice of truth.

Oh, what I would do to have the kind of strength it takes to stand before a giant with just a sling and a stone surrounded by the sound of a thousand warriors shaking in their armor wishing they'd have had the strength to stand.

But the giant's calling out my name and he laughs at me reminding me of all the times I've tried before and failed. The giant keeps on telling me time and time again "Boy you'll never win, you'll never win."

But the voice of truth tells me a different story. The Voice of truth says "do not be afraid!" And the Voice of truth says "this is for My glory." Out of all the voices calling out to me I will choose to listen and believe the Voice of truth.

But the stone was just the right size to put the giant on the ground and the waves they don't seem so high from on top of them looking down. I will soar with the wings of eagles when I stop and listen to the sound of Jesus singing over me.

But the Voice of truth tells me a different story. The Voice of truth says "do not be afraid!" And the Voice of truth says "this is for my glory." Out of all the voices calling out to me I will choose to listen and believe, I will choose to listen and believe the Voice of truth.

I will listen and believe, I will listen and believe the Voice of truth, I will listen and believe, 'Cause Jesus you are the Voice of truth, And I will listen to you.. oh you are the Voice of truth.


Wednesday’s workday started off like many of our other days with pre-rounds. We start our days off in the Peds unit. We each visit our patients, complete focused histories and physicals, update old complaints, ask about new complaints, come up with assessments and plans, update charts, review vitals, labs, imaging, and meds, etc. Wednesday was a typical morning. Once pre-rounds were finished our team gathered for chai, reviewed questions we had about our patients, and one of the interns briefly presented a medical topic. As rounds were about to start, our “normal” routine was abruptly changed. Keep in mind that the only thing normal about our days here are the routine because something unexpected always happens. The Peds unit is basically divided into 2 large rooms, there are some additional small rooms and we typically have some patients in the ICU. The best way to explain the division is one room is full of children over about 3 yoa, and the other full of children under 3 yoa…although you will see children mixed between both the rooms. On a “normal” day our team, including myself, 2-3 interns, 2 medical students, and 1-2 attendants, would start our rounds in the room with the older children…it has occurred this way every day I have been here except this Wednesday. As we all stood to walk toward the room with the “older” children, one of our attendants, Dr Allysa, suggested we change things up and start in the other room today. She said, “We always save the smaller children for last, let’s start with them today.” Of course none of us cared, so we all walked into the room with the younger children. Our first bed was Von’s patient, a 4 yo girl who presented to the clinic with epistaxis (nosebleed) and shortness of breath on Monday night. This morning Von received the results from the patient’s tests confirming his suspicions of leukemia. At this point all we could do for the girl was to provide palliative care. Dr Allysa said, “We need to make her comfortable. If she needs more oxygen, then give her more oxygen. If she needs something to drink, then give her something. Talk with the mom about her prognosis and about a DNR.” Although this was Von’s patient, Elijah spoke the native language of the family, so he stayed back to talk with the mom. In the unit each bed is within 2 feet of one another, so we moved to our next patient who was directly next to this girl. Von was presenting the next patient, but I was unable to focus on a single word he was saying. I looked back at Elijah and the mom who were sitting on the bed next to the little girl, and he was in prayer with her. After a few minutes Elijah got up and joined the rest of our team who was still at the next bed. I looked at the mom who was crying, so I walked over to try to console her….I didn’t speak her language, so I started rubbing her back. Elijah joined me and placed a hand on her. The mom looked at her baby girl and noticed she had stopped breathing….she noticed before we did. She began to cry out, looking to the ceiling and screaming words I couldn’t understand. The team rushed back over to check the status of the little girl. Elijah and I stayed by the mom…she was unable to stand and slid to the floor, still crying out. Someone from the team scooped the little girl up and carried her away, another person sent for the chaplain. It all happened so fast. The chaplain came to try to calm the mother, and the nurses assisted the mom to where the child had been taken. Resuscitations were not attempted on the child because the mom had given Elijah a verbal consent for a DNR. We all were aware of the child’s prognosis, but I don’t believe any of us expected for it to occur so suddenly. I fought back tears as we finished the rest of rounds that morning.
It took me awhile to put my thoughts together on this experience. For one I have never seen a child pass. For two I have never witnessed such an abundantly clear example of God’s power. We had no reason to switch our routine that morning, but we did. On our typical day, we would have just started rounding in the opposite room and no one would have been with that child and mother, no one would have gotten to pray with them. Within minutes of Elijah’s prayer over the child and mother, God took the child up to be with Him! It was such a powerful moment to experience! The power of prayer was so vivid! It brings tears to my eyes even now! It was a moment I will always reflect upon! God’s work is mysterious to me, although it is clear and I trust fully in Him!

Week #3 - It Takes Time to Adjust

The Nerve Graft!



Monday: An abundance of death. Over the weekend we had 4 children to pass away, three were from the NICU and one I had previously blogged about that was from peds. The child in the pediatric unit was one of my patients from last week. She was a 4 month baby girl whom presented with what we thought was pneumonia. After a few days of treatment the child was still hypoxic and presenting with a cough. The mom seemed to think the baby was getting better and clinically we thought she was making progress. Last Wednesday I ordered a repeat CBC and CXR under the suspicion that there might be something else going on...my attending, Dr Cheryl Lee, agreed with me. Thursday, the results from the tests showed miliary tuberculosis. Mortality rate for miliary TB are 16-38%, and if RDS (respiratory distress syndrome) develops mortality rises to 80-100%. Treatment was automatically transferred to provide coverage for TB. On Sunday the mother noticed the child had stopped breathing and a code was called...they were unable to resuscitate her. I was not present during the code, only on-call works on Sunday, but I was informed of the news when I returned to work on Monday. I was quite astonished...out of all the children on our service, she was not one that I expected to die. Dr Lee described our patients perfectly when she was asked how everyone was doing, "Everyone is stable, but borderline. It would not be surprising to see any of our children survive or die." Here at Tenwek Hospital you truly have to leave everything in God's hands each day! Our resources are limited and these children are severely ill. We can treat our patients to the best of our ability and resources, but it is in God's hands to heal them! In the US I often find that I must force or at least remind myself to rely on God throughout my day, here at Tenwek it is a necessity to get through the day! I hope to carry my new found reliance back to the US with me! God had a bigger plan for those 4 children, one that we may or may not understand. Ultimately though, my faith is in God and I trust in His works!

Tuesday: My break from Peds. As I had spoke with many of my friends about, I was initially under the impression that I was going to be doing Orthopedic Surgery here at Tenwek. A week before I left the states there was some confusion and I ended up in Pediatrics. I believe that God's hand played a part in some of the confusion that took place, because He is truly using me in the Peds Unit and NICU. Although I love my children and all the doctors on my service, I took a break on Tuesday to be part of the orthopedic team! Dr Trent Wilson is an orthopedic surgeon who is also a short-term missionary staying at the guesthouse. Once he found out I was interested in ortho, he was gracious enough to extend an invitation for me to join his service! Of course I accepted! Tuesday morning I scrubbed-in for my first surgery ever!!! I have been privileged enough to observe some surgeries, but I have never scrubbed-in!!! In the states these opportunities are rare due to the risk of lawsuits, but in Kenya any help is more than welcomed! Our first patient of the day was a female patient in her mid 30's that had been hit by a machete on her right humerus. And when I say hit by a machete, I mean the blow sliced through her arm and completely separated her humerus into two parts. The wound was left to heal over a 6-month period; needless to say it did not heal! As Trent and I scrubbed-in he mentioned to me that if I felt weak at any point just to make him aware...of course I was like haha, it happened once and it won't happen again! After about an hour into this stellar surgery I became very hot, nauseous, and starting getting very weak. I did not want to succumb to defeat, but it got to the point where my options were to step back and sit down or fall on top of our patient. The heat of being layered up and standing in a hot room for an hour finally overcame me. I ended up having to lay down with my legs propped up for about 30 minutes before I got enough energy to bear my weight. I decided to observe the rest of the patients until I was able to get some food at lunch. The next patient was a gunshot wound that had got infected. The patient had two huge holes going through his left thigh...an entry wound and an exit wound. On x-ray the proximal end of his femur was shattered. During lunch I was able to eat a large portion of food to regain my energy. As soon as I returned to theater (surgery) I was ready for round two! Dr Greene, a long-term missionary of Tenwek, was in need of an extra set of hands, so I stepped in to assist him! In 32 years of practice Dr Greene had never performed a nerve graft, and I was picked to assist him today!!!! Our patient was a 20 yo male who had also been attacked with a machete and had two defense lacerations on his left forearm. Repairs had been made the previous day to his ulna bone, but paralysis was noticed in the fingers his ulnar nerve supplied. When a repair was attempted yesterday it was unsuccessful because the ulnar nerve had been lacerated and the two ends of the nerve would not stretch far enough for reattachment. Today our objective was to remove the sural nerve from the leg and graft it into the ulnar nerve so that it would be continuously connected. In order to remove the sural nerve we had to make an incision on the posterior part of the left lower leg from the knee joint down to the ankle. Once the nerve was removed, incision was closed with stitches...staples do not exist at Tenwek because they are too expensive. Not only are your resources limited in Kenya, but part of the dilemma lies in the patient not being able to afford the right treatment. When treating your patients you often have to consider how much the treatment is going to cost the patient. After closing the leg, we quickly moved to our next incision site. Dr Greene reopened the previous wound and we cleaned out the site. The sural nerve that we pulled from the leg was tremendously smaller than the ulnar nerve, so we had to slice it into multiple shorter pieces. The work was tedious and meticulous, taking a total of 3 1/2 hours and inserting a total of 6 small segments between the two branches of the ulnar nerve. What may seem boring to some was one of the top most amazing things I have ever done throughout my life!!! It was a bit surreal! Needless to say I enjoyed my day very much and I plan on returning back to ortho one day next week for more experience! One of most amazing things I witnessed throughout my day in surgery was that prior to each surgery the team prayers with every patient! I can only imagine how much more at peace each patient must feel just knowing they are in God's presence!

The Humerus Repair!





The Gun Shot Wound!

Weekend #2 = Friends, Fellowship, Fun!!!

What an amazing weekend filled with friends, fellowship, and fun!!!
















On Saturday myself, Nathan, Lyle, Trent, Todd, and Anette journeyed on a 4-mile hike to the peak of Motigo Mountain. It was absolutely stunning!! The views were incredible...I stood in awe of God's creations! It was a morning filled with bonding and fellowship! We took our time on our 4-hour adventure and we were able to capture God's beauty in some of our pictures...I can't wait to post them! On our journey to the top we passed a church that was in the midst of a worship/prayer service. We were welcomed and encouraged to join, so we stopped by to enjoy the music coming from the choir. After a few songs, we continued on our hike to the peak of the mountain! It was a glorious site! The view was breathtaking! We stayed for awhile to take in all the beauty that surrounded us and to enjoy the company of some of the native children! A short time later we began our trek back down the mountain. Thanks be to God, when the daily rain began to settle in we were passing a locals home whom Todd happened to know. We were invited in to take chi tea. To many in the US this home would be considered a shack, but to the Kenyans this home was above standards. It amazes me how very welcoming every Kenya is! We sat as the rain passed over us in this Kenya home, everyone taking chi except me (I don't really care for the taste of chi) and sharing in fellowship! It was an uplifting experience! Once the shower had passed, we continued back down the mountain. As we passed back by the church we were invited to come say some words in front of the congregation. The reason for this "Prayer Day" was in preparation for the high-school exit test. The community gathered to pray over the children as they prepared for their studies. The education system is quite different here...one test can truly determine your future! We all walked to the front of this overfilled church and the pastor welcomed each of us! We each took a moment to introduce ourselves, say a short message, and to thank them for letting us share in their worship. Todd prayed for the children, then we exited the church. On the outside of the church many children stood that were unable to find room on the inside. All of the children wanted to shake our hands and to take pictures with us...we were so very honored! It was an incredible experience! Throughout the rest of our decent we were greeted by children running along side of us...it still amazes me how friendly all the natives are!







On Sunday myself and Lyle were invited to return home with an intern, Elijah, and join him at his church. This morning started off with about a 2-hour ride through Kenya. The sites were breathtaking! Tea leaves are grown throughout Kenya and tea factories exist everywhere! The tea crops are a bright green and make the mountainsides stunning! Our destination was Elijah's parents home. In Kenya anytime guest are expected, food is prepared. We had a wonderful Kenyan breakfast waiting for us when we arrived. I was very honored to meet Elijah's mother, father, and one of his 10 siblings! Large families are traditional and are only beginning to get smaller with this generation. After a wonderful breakfast and being welcomed into Elijah's childhood home, we were able to take many pictures to capture our experience! Shortly after we piled back into the car to head to church. We were among the first to arrive...Kenya time is slow time, so many ventured in late! The service lasted about 2 1/2 hours. It was such an incredible experience!!! About 30 minutes into the service and the entire church was filled...there were no seats left available!! One of my many thoughts was why are the churches in the US not this full?? Why are there seats left available during our worship services?? We have so much to be thankful for in the US...we are so blessed, so why is that the Kenya's who are given so little are so much more thankful?? Why is it that the Kenya's live out their faith so much better than us Americans? I was left baffled by the worship experience that I took part of this morning. Shouldn't every worship experience in every church be so uplifting? My brothers and sisters in Kenya welcomed me before the congregation to say a few words...it was a powerful experience! The sermon was given in part by Lyle with Elijah translating, then Elijah finished up the last half of the message. HIV/AIDS is such a huge issue in Kenya and one that carries a stigma. The topic for the sermon was education/treatment for HIV/AIDS and how to love and care for those carrying the disease. It was a message that was well accepted! The gospel used to support the message was Matthew 15:29-31, "Jesus left there and went along the Sea of Galilee. Then he went up on a mountainside and sat down. Great crowds came to him, bringing the lame, the blind, the crippled, the mute and many others, and laid them at his feet; and he healed them. The people were amazed when they saw the mute speaking, the crippled made well, the lame walking and the blind seeing. And they praised the God of Israel." Jesus healed the sick, so we must treat the sick as Jesus did! The 2 1/2 hours was filled with praise, worship, fellowship, and love! At the end of the service 4 cokes were brought out...one for myself, Lyle, Elijah, and Elijah's wife, Emily. Guest are always greeted with a treat...and in Kenya a coke would be considered a treat for most! For those that don't know me, I have not had a soda since I was in middle school. It was impossible for me to turn down such hospitality...they were honoring me, and it would have been rude for me not to accept! So after almost 18 years I had my first coke today! I have to admit it wasn't bad, but I think I'll stick with my water. As we were exiting the church after service, the crowd continued to follow us to the car. Our car was surrounded with children and adults wanted to greet us, just to shake our hands. Many reached in to the car to touch us...it was a very surreal experience! We made our way through the crowd and began our journey back to Tenwek! What an amazing way to start my Sunday!!!

Elijah's parent's home. His mother made breakfast for us!

Elijah's families tea fields! Tea fields are in abundance in Kenya.

Elijah's family:

Church:









In preparation for this coming week I ask all that are following my journey to pray for the sick here at Tenwek! Pray for those that don't have a relationship with God! And pray for those that live in despair!

While I am praying over those here in Kenya, I am also remembering my church family at the Gathering at Hillvue Heights Church in my prayers! I am blessed to have such a strong group of believers as my church family! I miss them dearly and I pray that they are continuing to preach the gospel in our Bowling Green community and that others are coming to know Christ through them! Be an example...be a missionary as we are all called to be! No matter where you are today, follow Christ and share the gospel!